Emergency care assessment, psychological considerations


Emergency care
Emergency care can be defined as the episodic and crisis-oriented care provided to patients with serious or potentially life-threatening injuries or illnesses
Initial Assessment: Form a general impression of the patient
Assess the Patient's Mental Status:
Classify the patient's mental status into one of the following categories:
·        Alert
·        Verbal
·        Painful
·        Unresponsive
The primary survey: Mnemonic ABCD
·        Does the patient have an open airway?
·        Is the patient able to speak?
·        Check for airway obstructions such as loose teeth, foreign objects, bleeding, vomits or other secretions.
·        Treat immediately

·        Is the patient breathing?
·        Assess for equal rise and fall of the chest
·        Respiratory rate and pattern     
·        Skin color
·        Use of accessory muscles
·        Integrity of the chest wall
·        position of the trachea.
·        Palpate a central pulse?
·        What is the quality (strong, weak, slow, rapid)?
·        Is the skin warm and dry?  
·        Is the skin color normal?
·        Obtain a blood pressure
·        Assess level of consciousness and pupils
·        Assess level of  by GCS scale:
·        Is the patient alert?
·        Does the patient respond to voice?
·        Does the patient respond to painful stimulus?
·        The patient is unresponsive even to painful stimulus.
Secondary Assessment: Mnemonic:"EFG"
Head, neck, Chest, Abdomen
Examine for any injuries
Environmental control: prevent heat loss by using warm blankets, overhead warmers, and warmed I.V. fluids

Full set of vital signs
·        Obtain a full set of vital signs
·        obtain blood pressure in both arms if chest trauma is suspected.
Five interventions
·        cardiac monitoring 
·        pulse oximetry to measure the oxygen saturation
·        Indwelling urinary catheter
·        gastric tube
·        Laboratory studies
Ø Blood group and cross matching
Ø hemoglobin and hematocrit
Ø urine drug screen
Ø blood alcohol,
Ø electrolytes
Ø prothrombin time (PT) and partial thromboplastin time
Ø pregnancy test if applicable
Facilitate family presence
If any member of the family wishes to be present-during-the-resuscitatjon, it is imperative to assign a staff member to that person to explain what is being done and offer support
Give comfort measures: verbal reassurances as well as pain management.
          Focused History & Physical Exam - Trauma
·        Re-evaluate Mechanism of Injury (MOI) 
·        Significant MOI? Yes/No
o   Is patient unresponsive or disoriented?        
·        Is patient under the influence of drugs or alcohol?
·        Patients with Significant MOI
·        D - Deformities
·        C - Contusions
·        A - Abrasions
·        P - Punctures/Penetrations
·        B - Burns
·        T - Tenderness
·        L - Lacerations
·        S -Swelling
Quickly Obtain Baseline Vital Signs
S-A-M-P-L-E History
S - Signs & Symptoms
A – Allergies: Medications, Foods, Environment
M - Medications
·        Are you taking any?
·        When did you last take your medication?
·        What are they?
·        What are they for?
·        May I see them?
P - Previous Medical History
·        Pertinent
·        Related to this complaint
·        Complicating factor
L - Last Oral Intake Food and/or Drink?
·        What?
·        When?
E - Events leading up to the incident
·        What happened?
·        When?
Physical assessment
Head-to-Toe Assessment patient's general appearance, including body position or any guarding or posturing.
Head and face
·        Inspect for any lacerations, abrasions, contusions, puncture wounds, ecchymosis, edema Palpate for crepitus, crackling, or bony deformities.

·        Inspect for breathing effectiveness, paradoxical chest wall movement, disruptions in chest wall integrity.
·        Auscultate for bilateral breath sounds and heart sounds
·        Palpate for bony crepitus or deformities
·        Inspect for lacerations, abrasions, contusions, puncture wounds, ecchymosis, edema, scars or distention.
·        Auscultate for the presence of bowel sounds.
·        Palpate for rigidity, guarding, masses, or areas of tenderness Pelvis/perineum
·        Inspect for lacerations, abrasions, contusions, puncture wounds, ecchymosis, edema, or scars
·        Look for blood at the urinary meatus.
·        Palpate for pelvic instability and anal sphincter tone
·        Inspect skin colour and temperature.
·        Look for signs of injury and bleeding.
·        Does the patient have movement and sensation of all extremities?
·        Palpate peripheral pulses
·        Bony crepitus Areas of tenderness
·        Posterior surfaces
·        Inspect for possible injuries-
·        Palpate the vertebral column and all tenderness
Focused Assessment
Any injuries that were identified during the primary and secondary sunseys require a detailed assessment.
Approach to the Patient
·        Understand and accept the basic anxieties of the acutely traumatized patient.
·        Understand and support the patient's feelings concerning loss of control.
·        Treat the unconscious patient as if conscious.
·        Avoid making negative comments about the patient's condition. Be prepared to handle all aspects of acute trauma know what to expect and what to do.
Approach to the Family
·        Inform about patient admission unit
·        Give as much information about the treatment.
·        Allowing a family member to be present during the resuscitation.
·        Recognize the anxiety of the family
·        Acknowledge expressions of anger, guilt, and criticism. Deal with reality as gently and quickly as possible Avoid encouraging and supporting denial.



anaphysio,4,ASEPSIS AND INFECTION CONTROL,9,audio,1,biochemistry,2,blog,1,BSN Notes: Assessment in Psychiatry,6,BSN Notes: Burns,11,BSN Notes: Care of Terminally Ill Patients,6,BSN Notes: Childhood and Developmental Disorders,6,BSN Notes: Common Behavioural and Social Problems,4,BSN Notes: Common Childhood Diseases,7,BSN Notes: Common Signs And Symptoms,32,BSN Notes: Community Mental Health Nursing,12,BSN Notes: Critical Care,12,BSN Notes: Disaster and Emergency,15,BSN Notes: ENT,8,BSN Notes: Eye,25,BSN Notes: History and Assessment,24,BSN Notes: Introduction of Psychiatry,27,BSN Notes: Legal Issues In Psychiatry,4,BSN Notes: Medication Administration,24,BSN Notes: Neuritic_Stress related and Somatization Disorders,10,BSN Notes: Neurology,6,BSN Notes: Oncological Nursing,8,BSN Notes: Organic Brain Disorders,1,BSN Notes: Oxygenation,3,BSN Notes: Personality_Sexual and Eating Disorders,5,BSN Notes: Principles and Concepts of Psychiatry Nursing,2,BSN Notes: Psych-pharmacology and Other Treatment Modalities,30,BSN Notes: Psychiatry Emergencies and Crisis Intervention,4,BSN Notes: Psychosocial Needs,5,BSN Notes: Schizophrenia and othe Psychotic Disorders,4,BSN Notes: The healthy child,5,BSN Notes: TNPR,9,BSN Notes: Urinary Elimination,14,chn,41,clinicalkannada,4,clinicals1,40,clinicals2,13,clinicals3,33,clinicals4,17,Code of Ethics,3,community,7,Critical thinking,7,drugs,3,Epidemiological Approach,4,Equipment & Linen,9,Equipments & Linen,1,Etics and Legal,1,exa,1,exam,11,featured,19,fon,142,fon3,142,fun,1,geriatric,1,goingbacktodraft,673,graphic,1,Growth and Development,5,he,115,hotspot,6,kannada,63,language,1,Machinery,10,Medications,1,Memory Tools,9,mhn,127,microbiology,3,misc,2,mnemonics,48,msn,137,NCLEX,13,ncp,27,news,4,obg,28,OBG Medications,1,Peri- operative Nursing,2,pharma,29,Physical Examination and Assessment,9,Psychology,2,Pulse,7,resources,1,Respiration,4,Transitional care,1,Ventilators,5,voice,2,
notes.nursium.com: Emergency care assessment, psychological considerations
Emergency care assessment, psychological considerations
Loaded All Posts Not found any posts VIEW ALL Readmore Reply Cancel reply Delete By Home PAGES POSTS View All RECOMMENDED FOR YOU LABEL ARCHIVE SEARCH ALL POSTS Not found any post match with your request Back Home Sunday Monday Tuesday Wednesday Thursday Friday Saturday Sun Mon Tue Wed Thu Fri Sat January February March April May June July August September October November December Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec just now 1 minute ago $$1$$ minutes ago 1 hour ago $$1$$ hours ago Yesterday $$1$$ days ago $$1$$ weeks ago more than 5 weeks ago Followers Follow THIS CONTENT IS PREMIUM Please share to unlock Copy All Code Select All Code All codes were copied to your clipboard Can not copy the codes / texts, please press [CTRL]+[C] (or CMD+C with Mac) to copy